Compromiso y atrincheramiento con la carrera entre enfermeros de la Atención Primaria

Lourenção, Luciano Garcia; Silva, Rosana Aparecida de Souza da; Moretti, Marli dos Santos Rosa; Sasaki, Natália Sperli Geraldes Marin dos Santos; Sodré, Paula Canova; Gazetta, Claudia Eli

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 55 • 2021 • https://doi.org/10.1590/1980-220X-REEUSP-2021-0186 copiar

Compromiso y atrincheramiento con la carrera entre enfermeros de la Atención Primaria^** Extracted from the thesis: “Comprometimento e entrincheiramento com a carreira de enfermeiros da Atenção Primária à Saúde”, Faculdade de Medicina de São José do Rio Preto, Programa de Pós-Graduação em Enfermagem, 2021.

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Evaluar el compromiso y el atrincheramiento con la carrera entre enfermeros de cuidados de la Atención Primaria a la Salud.

Método:

Ha sido realizado un estudio transversal en 2018, con enfermeros de la atención primaria de dos ciudades paulistas. Se utilizaron las Escalas de Compromiso y de Atrincheramiento con la Carrera, convalidadas en Brasil, y compuesta por 12 temas cada, que evalúan: identidad, resiliencia y planificación, relacionados al compromiso; costos emocionales, inversiones y limitación de alternativas en la carrera, referentes al atrincheramiento.

Resultados:

El score promedio del compromiso (61,4 puntos) fue mayor del que el de atrincheramiento con la carrera (57,8 puntos); el factor identidad obtuvo nivel alto (70,9 puntos); resiliencia y planificación en la carrera obtuvieron niveles medios (62,5 y 50,8 puntos, respectivamente). El atrincheramiento con la carrera (57,8 puntos) y sus respectivos factores obtuvieron niveles medios (inversiones: 57,7 puntos; limitación de alternativas: 58,8 puntos; costos emocionales: 57,0 puntos).

Conclusión:

Los enfermeros presentaron en mayor proporción gran vínculo de compromiso con la carrera, una vez que presentaron mayor vínculo de identificación y relación positiva, más que de estagnación con la carrera.

DESCRIPTORES
Movilidad Laboral; Enfermería del Trabajo; Ambiente de Trabajo; Atención Primaria de Salud; Enfermería

Variables	Municipality A	Municipality B
Variables	n (%)	n (%)
Total	77 (100.0)	15 (100.0)
Sex
Male	5 (5.2)	1 (6.7)
Female	72 (93.5)	14 (93.3)
Did not answer	1 (1.3)	–
Age range
From 20 to 30 years	16 (20.8)	1 (6.7)
From 31 to 40 years	32 (41.6)	9 (60.0)
From 41 to 50 years	19 (24.7)	3 (20.0)
51 years or above	6 (7.8)	2 (13.3)
Did not answer	4 (5.2)	–
Marital status
Married	44 (57.1)	12 (80.0)
Single	27 (35.1)	2 (13.3)
Divorced	5 (6.5)	–
Widow(er)	1 (1.3)	1 (6.7)
Level of education
Undergraduate course	10 (13.0)	3 (20.0)
Graduate certificate	63 (81.8)	12 (80.0)
Master degree	2 (2.6)	–
PhD	2 (2.6)	–
Type of agreement
Selected for public job	53 (68.8)	12 (80.0)
Hired	24 (31.2)	3 (20.0)
Family income (in minimum salaries)*
Two to five	24 (31.2)	10 (66.7)
Six to 10	39 (50.6)	2 (13.3)
More than 10	12 (15.6)	3 (20.0)
Did not answer	2 (2.6)	–
Health unit manager
Yes	31 (40.3)	9 (60.0)
No	46 (59.7)	6 (40.0)
Length of work at PHC
Up to two years	17 (22.1)	2 (13.3)
Two to five years	21 (27.3)	5 (33.3)
Six to 10 years	16 (20.8)	2 (13.3)
11 to 20 years	20 (26.0)	4 (26.7)
More than 20 years	1 (1.3)	2 (13.3)

Relationships with career	Standardized means (±sd)	Classification
Career commitment	61.4 (±6.8)	Medium
Identification with career	70.9 (±10.3)	High
Planning with career	50.8 (±10.5)	Medium
Resilience with career	62.5 (±17.5)	Medium
Entrenchment with career	57.8 (±7.6)	Medium
Investments in the career	57.7 (±18.2)	Medium
Limitation of alternatives in the career	58.8 (±8.7)	Medium
Emotional costs in the career	57.0 (±10.1)	Medium

Relationships with career	Standardized means (±sd)		p-value*
Relationships with career	Municipality A	Municipality B	p-value*
Career commitment	61.2 (±7.2)^a	62.4 (±4.3)^a	0.833
Identification with careers	70.7 (±9.5)^b	72.0 (±14.0)^b	0.779
Planning with career	50.0 (±10.4)^a	55.0 (±10.0)^a	0.286
Resilience with career	62.9 (±17.9)^a	60.3 (±15.9)^a	0.460
Career entrenchment	57.6 (±7.3)^a	59.0 (±8.7)^a	0.346
Investments in the career	58.3 (±17.8)^a	55.0 (±20.2)^a	0.963
Limitation of alternatives in the career	58.1 (±9.0)^a	62.4 (±6.3)^a	0.115
Emotional costs in the career	56.4 (±10.1)^a	59.7 (±10.3)^a	0.495

Sociodemographic and professional variables	Career commitment				Career entrenchment
Sociodemographic and professional variables	Identification	Planning	Resilience	General construct	Investments	Limitation of alternatives	Emotional costs	General construct
Sex
Male	67.0 (±6.7)^a	51.0 (±10.2)^a	58.0 (±13.0)^a	58.7 (±8.8)^a	52.2 (±14.4)^a	63.0 (±2.7)^a	60.0 (±5.0)^a	58.3 (±5.9)^a
Female	71.3 (±10.3)^b	50.7 (±10.5)^a	62.6 (±17.8)^a	61.5 (±6.7)^a	58.3 (±18.4)^a	58.5 (±8.9)^a	57.0 (±10.2)^a	57.9 (±7.6)^a
p-value	0.363	0.237	0.950	0.487	0.882	0.398	0.016	0.270
Level of education
Undergraduate course	72.7 (±10.1)^b	50.4 (±6.3)^a	58.9 (±15.6)^a	60.6 (±5.1)^a	49.6 (±21.6)^a	57.8 (±8.5)^a	54.6 (±11.6)^a	54.0 (±9.0)^a
Graduate certificate	70.9 (±10.2)^b	51.5 (±10.6)^a	63.2 (±17.9)^a	61.8 (±6.8)^a	59.4 (±17.1)^a	58.9 (±9.0)^a	57.7 (±9.9)^a	58.6 (±7.0)^a
Master’s degree	67.5 (±17.7)^a	45.0 (±7.1)^a	62.5 (±17.7)^a	58.3 (±14.1)^a	65.0 (±14.1)^a	65.0 (±0.0)^a	55.0 (±7.1)^a	61.7 (±7.1)^a
PhD	62.5 (±10.6)^a	35.0 (±21.2)^a	60.0 (±28.3)^a	52.5 (±1.2)^a	40.0 (±28.3)^a	57.5 (±3.5)^a	47.5 (±10.6)^a	48.3 (±11.8)^a
p-value	0.227	0.588	0.138	0.872	0.044	0.141	0.755	0.416
Type of agreement
Selected for public position	70.4 (±9.7)^b	52.2 (±10.1)^a	64.5 (±17.1)^a	62.4 (±6.6)^a	60.8 (±16.1)^a	58.7 (±8.2)^a	57.7 (±9.7)^a	59.0 (±6.4)^a
Hired	72.0 (±11.7)^b	47.6 (±10.8)^a	57.6 (±18.0)^a	59.1 (±6.8)^a	50.4 (±20.9)^a	59.1 (±10.0)^a	55.2 (±11.1)^a	54.9 (±9.3)^a
p-value	0.033	0.485	0.056	0.084	0.015	0.012	0.860	0.282
Length of work at PHC
Up to two years	75.0 (±10.3)^b	48.4 (±9.0)^a	53.4 (±17.6)^a	58.9 (±7.5)^a	47.9 (±20.5)^a	54.5 (±9.7)^a	61.6 (±9.1)^a	54.6 (±9.4)^a
Two to five years	69.4 (±10.7)^a	53.3 (±11.9)^a	62.9 (±16.7)^a	61.9 (±6.4)^a	55.4 (±15.9)^a	61.9 (±8.3)^a	56.4 (±9.2)^a	57.9 (±5.5)^a
Six to 10 years	67.8 (±9.4)^a	50.6 (±8.0)^a	70.0 (±16.9)^b	62.8 (±6.3)^a	63.9 (±11.8)^a	59.7 (±6.5)^a	56.7 (±9.2)^a	60.1 (±5.3)^a
11 to 20 years	72.1 (±9.8)^b	49.6 (±12.2)^a	62.7 (±17.8)^a	61.6 (±7.0)^a	62.3 (±20.7)^a	57.2 (±9.0)^a	55.4 (±12.5)^a	58.3 (±9.3)^a
Above 20 years	63.3 (±11.5)^a	55.0 (±8.7)^a	60.0 (±8.7)^a	59.4 (±2.5)^a	71.7 (±7.6)^b	63.3 (±5.8)^a	50.0 (±0.0)^a	61.7 (±4.4)^a
p-value	0.468	0.129	0.536	0.074	0.221	0.022	0.040	0.205

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Luciano Garcia Lourenção, Rua General Osório, s/nº, 4º piso, Centro, 96201-900 – Rio Grande, RS, Brazil, lucianolourencao.enf@gmail.com